NPI | 1609660638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351054557) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351054557) |
Enumeration Date | 2025-04-07 |
Last Update Date | 2025-06-19 |